• Obaid Kousha, Zubaid Kousha, and Jonathan Paddle.
• Critical Care Unit, Royal Cornwall Hospital, Royal Cornwall Hospitals NHS Trust, Treliske, Truro TR1 3LJ, United Kingdom. Electronic address: okousha@nhs.net.
• J Crit Care. 2018 Apr 1; 44: 413-418.

PurposeWe aimed to determine the rate of exposure keratopathy (EK) in critically ill patients, identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK.Materials And MethodsWe undertook a two-phase prospective cohort study in a general adult ICU with first-phase being observational and an eye care protocol was introduced in the second-phase. Daily ophthalmic assessment was carried out along with recording of various risk factors.ResultsWe studied 371 patients. In the first phase, the overall rate of EK was 21% but the rate in mechanically ventilated patients was 56%; χ2 (1, N=257)=80.8, p<0.001. Adjusted odds ratios (AOR) for development of EK was 28.6 (8.19-43.37), 13.0 (3.16-54.38) and 1.2 (1.03-1.33) with incomplete eye closure, mechanical ventilation, and higher sequential organ failure assessment score respectively. Following the introduction of the protocol, the overall rate of EK reduced to 2.6% (3 cases); χ2 (1, N=371)=18.6, p<0.001.ConclusionsEK is common in critically ill patients and a simple protocol substantially reduces the incidence of EK and is easily achieved in clinical practice.Copyright © 2017 Elsevier Inc. All rights reserved.

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